The Impact of Neoadjuvant Chemotherapy on Ovarian Cancer Tumor Microenvironment: A Systematic Review of the Literature.
Details
Serval ID
serval:BIB_6C1598EE7D8E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The Impact of Neoadjuvant Chemotherapy on Ovarian Cancer Tumor Microenvironment: A Systematic Review of the Literature.
Journal
International journal of molecular sciences
ISSN
1422-0067 (Electronic)
ISSN-L
1422-0067
Publication state
Published
Issued date
27/06/2024
Peer-reviewed
Oui
Volume
25
Number
13
Language
english
Notes
Publication types: Journal Article ; Systematic Review ; Review
Publication Status: epublish
Publication Status: epublish
Abstract
Immunotherapy, particularly the use of immune checkpoint inhibitors (ICIs), has shown limited efficacy in treating ovarian cancer (OC), possibly due to diverse T cell infiltration patterns in the tumor microenvironment. This review explores how neoadjuvant chemotherapy (NACT) impacts the immune landscape of OC, focusing on tumor-infiltrating lymphocytes (TILs), PD-1/PD-L1 expression, and their clinical implications. A comprehensive literature search across four databases yielded nine relevant studies. These studies evaluated stromal (sTILs) and intra-epithelial (ieTILs) TILs before and after NACT. sTIL responses varied, impacting prognostic outcomes, and ieTILs increased in some patients without clear survival associations. PD-L1 expression after NACT correlated with improved overall survival (OS), and increases in granzyme B+ and PD-1 correlated with longer progression-free survival (PFS). Remarkably, reduced FoxP3+ TILs post-NACT correlated with better prognosis. NACT often increases sTIL/ieTIL and CD8+ subpopulations, but their correlation with improved PFS and OS varies. Upregulation of co-inhibitory molecules, notably PD-L1, suggests an immunosuppressive response to chemotherapy. Ongoing trials exploring neoadjuvant ICIs and chemotherapy offer promise for advancing OC treatment. Standardized measurements assessing TIL density, location, and heterogeneity are crucial for addressing genetic complexity and immunological heterogeneity in OC.
Keywords
Humans, Tumor Microenvironment/drug effects, Female, Neoadjuvant Therapy/methods, Ovarian Neoplasms/drug therapy, Ovarian Neoplasms/pathology, Ovarian Neoplasms/metabolism, Lymphocytes, Tumor-Infiltrating/immunology, Lymphocytes, Tumor-Infiltrating/metabolism, Lymphocytes, Tumor-Infiltrating/drug effects, B7-H1 Antigen/metabolism, Prognosis, Programmed Cell Death 1 Receptor/antagonists & inhibitors, Programmed Cell Death 1 Receptor/metabolism, Immune Checkpoint Inhibitors/therapeutic use, Immune Checkpoint Inhibitors/pharmacology, NACT, TILs, ovarian cancer
Pubmed
Web of science
Open Access
Yes
Create date
19/07/2024 14:10
Last modification date
26/07/2024 7:02